By Dr. Bloomfield.
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Spend 60 seconds a day thinking about your health.
The term "obesity" refers to an excess of fat. However, the methods used to directly measure body fat are not available in daily practice for your local Personal Trainer Sydney CBD. For this reason, obesity usually is assessed by the relationship between weight and height (ie, anthropometrics), which provides an estimate of body fat that is sufficiently accurate for clinical purposes.
The body mass index (BMI) is the accepted standard measure of overweight and obesity for children two years of age and older. BMI provides a guideline for weight in relation to height and is equal to the body weight (in kilograms) divided by the height (in meters) squared.
Adults with a BMI between 25 and 30 kg/m2 are considered overweight; those with a BMI ≥30 kg/m2 are considered to be obese. Obesity in adults is subcategorized as class I (BMI ≥30 to 35), class II (BMI ≥35 to 40), and class III (BMI ≥40). Because children grow in height as well as weight, the norms for BMI in children vary with age and sex. If you find yourself overweight or obese, a personal trainer in the Sydney CBD might be able to help.
For some reason, this winter your Personal Trainer Sydney CBD has noticed that gastro has been rampant amongst his clients.
People ask, what can I do?
The short answer is, not a lot. Acute viral gastroenteritis is usually self-limited and is treated with supportive measures (fluid repletion and unrestricted nutrition). No specific antiviral agents are available.
Fluid maintenance and repletion
For most adults who suffer with acute viral gastroenteritis, dehydration will be a major concern but generally fluid levels can be maintained with sport drinks and broths. For adults presenting with mild to moderate dehydration, the evidence suggests oral rehydration solutions may be superior to sports drinks in maintaining electrolyte balance along with hydration. Patients with severe dehydration require intravenous fluids. Soft drinks and fruit juices that are high in sugar content should be avoided.
In adults with acute viral gastroenteritis, we do not recommend adherence to any restricted diet. Patients should be encouraged to eat as tolerated. Smaller meals may be less likely to induce vomiting than larger ones. Bland, low residue foods may also be better tolerated than others. For healthy adults with acute viral gastroenteritis without signs of dehydration, sport drinks, diluted fruit juices, and other flavored soft drinks augmented with saltine crackers and broths or soups can meet the fluid and salt needs in almost all cases. Broiled starches/cereals (potatoes, noodles, rice, wheat, and oat) with some salt are excellent foods to consider. In addition, crackers, bananas, yogurt, soups, and boiled vegetables can also be consumed.
While the BRAT diet (bananas, rice, applesauce, and toast) is often recommended, the evidence to support it is weak. Similarly, while many authorities advise patients to exclude milk and dairy products from their diet during the episode of diarrhea and for several weeks after symptoms resolve, the evidence to support this is weak.
The value of oral probiotics in acute viral gastroenteritis is not well established, and further research is needed to determine the optimal type, dose, and regimen of probiotics before they are recommended for routine use.
The effect of zinc supplementation on duration of diarrheal illnesses in adults has not been studied, and its use is not the standard of care.
Antimotility agents (drugs that stop you pooping)
In adults younger than 65 years of age with acute viral gastroenteritis and with moderate to severe diarrhea or signs or symptoms of severe dehydration, a one- to two-day course of loperamide (4 mg orally, followed by 2 mg after each episode of diarrhea, up to 8 mg/day) may be appropriate. For adults ≥65 years of age, loperamide is not recommended for self-medication, and patients should be closely monitored if taking it under the guidance of a physician.
Antiemetics (drugs that stopyou vomiting)
Although studies in adult populations are lacking, for patients who cannot tolerate oral rehydration due to excessive vomiting, I suggest treating with an antiemetic (eg, prochlorperazine or ondansetron) as needed for one to two days to facilitate oral fluid repletion.
In adults who clearly have acute viral gastroenteritis (eg, outbreak with known etiology), I do not recommend the empiric use of antibiotics. In general, empiric therapy for community-acquired acute diarrhea (of unclear etiology) may be beneficial but does not appear to dramatically alter the course of illness in unselected populations. If patients initially treated with supportive measures do not improve after seven days or symptoms worsen, then they should be reevaluated and possibly treated for other causes of gastroenteritis.
When to hospitalize
Potential indications for hospitalization include the presence of alarm symptoms or signs, or individuals at risk for complications (eg, dehydration), including:
●Abnormal electrolytes or renal function
●Excessive bloody stool or rectal bleeding
●Severe abdominal pain
●Prolonged symptoms (more than one week)
●Age 65 or older with signs of hypovolemia
●Comorbidities (eg, diabetes mellitus, immunocompromised)
Personal trainer Sydney CBD really hopes you don't get gastro this winter but if you do, see your local doctor for further advice.
Tennis elbow or elbow tendinopathy affects many people who see a Personal Trainer Sydney CBD. Perhaps the most surprising this for most people who suffer from the condition is that they never actually played tennis.
So what is elbow tendinopathy? — Elbow tendinopathy is a condition that causes elbow pain and forearm weakness. Doctors use the term "elbow tendinopathy" when people have a problem with a tendon in the elbow. Tendons are strong bands of tissue that connect muscles to bones. Depending on which elbow tendon is injured, the condition is also known as "tennis elbow" or "golf elbow."
In most people with elbow tendinopathy, the tendons are not inflamed or swollen. If they do get inflamed or swollen, doctors call it "tendinitis."
Tendinitis usually starts suddenly. Tendinopathy usually happens over a longer period of time.
What causes elbow tendinopathy? — This condition can happen as people get older, especially if they do a lot of work or activity using their elbow and forearm. Tendinitis can happen when people get hurt or do the same movements over and over.
What are the symptoms of elbow tendinopathy? — The most common symptoms are:
●Elbow pain – The pain can start slowly or suddenly. It can spread to the upper arm or forearm.
●Weakness of the forearm muscles
●Swelling (if people have tendinitis)
Is there a test for elbow tendinopathy? — No. But your doctor or nurse should be able to tell if you have it by talking with you and doing an exam.
If you think you suffer from elbow tendinopathy and would like to get a treatment plan then get in touch with your local Personal Trainer Sydney CBD.
Approximately 1 in 6 Australians suffer from back pain every year. Thus, for a Personal Trainer Sydney CBD it is imperative to be able to take an accurate and detailed history of a patients back pain.
While it may not be possible to define a precise cause of low back symptoms for most patients, it is important to evaluate for evidence of specific etiologies of back pain. The history should include location, duration, and severity of the pain, details of any prior back pain, and how current symptoms compare with any previous back pain.
We should also ask about constitutional symptoms (eg, unintentional weight loss or night sweats), history of malignancy, precipitants or precipitating events, therapies attempted, neurologic symptoms (eg, weakness, falls or gait instability, numbness or other sensory changes, or bowel/bladder symptoms), stability or progression of symptoms, history of recent bacterial infections (particularly bacteremia), recent history or current use of injection drugs, history or current use of corticosteroid medications, and recent history of procedures in the back.
Patients should also be evaluated for social or psychologic distress that may be contributing. Potentially useful items are a history of failed previous treatments, substance abuse, and disability compensation. Screening for depression may be helpful.
Though less common, features that may suggest underlying systemic disease include history of cancer, age >50 years, unexplained weight loss, duration of pain >1 month, night time pain, and unresponsiveness to previous therapies. Injection drug use, recent bacterial infection (particularly bacteremia), or fever increase the suspicion of spinal infection.
If you've got back pain, get in touch today!
There are a number of questions that are important for differentiating the underlying cause of knee pain and these should be considered by all Personal Trainer Sydney CBD. These questions are important for narrowing the differential diagnosis and should be asked of every adult patient presenting with knee pain:
●Did pain begin following an acute traumatic event? Pain immediately following an injury is concerning for possible structural damage to the knee. Delayed pain suggests tendon strains, cartilage contusions, or minor soft tissue tears. The closer the pain onset is to the specific event, the higher the likelihood of significant structural damage.
●Is the pain associated with activity (eg, new exercise regimen, change in previous training habits, day-to-day activity over the preceding few months)? Pain associated with activity should lead to further inquiry about training equipment (eg, shoes, braces), training volume (eg, training days per week, duration of training sessions), intensity, and any recent changes in such parameters. Information about specific activities that trigger pain can be helpful. As an example, anterior knee pain associated with sprinting or jumping is a classic part of the history of patellar tendinopathy.
●In which anatomic quadrant is the pain located (anterior, posterior, lateral, or medial), or is the pain diffuse or vague? Localizing knee pain to an anatomic quadrant or more specific location helps circumscribe the differential diagnosis. Pinpoint localization is generally possible following trauma to a specific ligament, tendon, or other palpable anatomic structure. Pain described as diffuse or vague may be secondary to injury of an intra-articular structure, a rheumatologic or infectious process, or from referred pain.
●Has the painful knee been swollen (ie, joint effusion) or erythematous? Rapid swelling after trauma occurs with bleeding into the knee joint and suggests a significant injury (eg, anterior cruciate ligament tear). Swelling or erythema occurring without trauma may indicate an infectious, rheumatologic, or crystal-induced condition and diagnostic arthrocentesis is often indicated.
●Are constitutional symptoms, such as fevers, chills, night sweats, fatigue, or rash, present? The presence of such symptoms and signs suggests a systemic illness and further investigation of infectious, autoimmune, or neoplastic causes is necessary.
●Is there a history of prior knee injury or surgery? A past history of knee injury is the most accurate predictive risk factor for future knee injury. The clinician should inquire about the type of injury, duration of disability, and the rehabilitation program. Often, a new knee injury is a complication of an old or concurrent injury. As an example, patellofemoral pain can develop in patients who alter their running gait due to discomfort from chronic Achilles tendinopathy. Likewise, prior surgical repairs can "wear out" or fail, leading to recurrence of the initial condition. All patients with prior injury or surgery experience some degree of deconditioning while injured and recovering. This deconditioning, combined with poor or incomplete rehabilitation, predisposes to new injuries.
●Are there symptoms affecting any other joints? Subjective symptoms and/or examination findings that reveal multiple affected joints raise suspicion for a systemic or rheumatologic process.
●Is there a history of systemic or rheumatologic disease? A known history of a systemic or rheumatologic disease can help to guide clinical inquiry, physical examination, and possible laboratory testing.
Consider these questions and discuss the answers with your Personal Trainer Sydney CBD who will be able to help develop a management plan for you.
Many personal training sydney CBD clients find it difficult to maintain weight loss with lifestyle modification alone. In these cases, adding a medication may prove to be effective. Historically, not too many pharmacotherapies have survived the ire of the therapeutic goods administration. In addition, previous treatments such as phentermine-fenfluramine, rimonabant and sibutramine were withdrawn due to safety issues, resulting in lingering safety concerns.
There are however, four new therapeutic options in the wings, three of which may be approved in Australia shortly and one — liraglutide 3.0 mg — was approved in December 2015. Liraglutide is a glucagon-like peptide-1 receptor agonist that appears to act by increasing satiety and reducing food intake. Lorcaserin is a selective agonist of the serotonin2C receptor, which mediates anorecticactivity. The naltrexone/bupropion extended release (ER) combination utilises synergistic effects of the two component drugs, mediated via neurons in the hypothalamus, to reduce energy intake. Phentermine/topiramate ER combines the appetite suppressant phenterminewith topiramate, an anti-epileptic with appetite-suppressant effects. All can result in meaningful improvements in obesity-related diseases, including diabetes and cardiovascular disorders.
The landscape of obesity treatment in Australia is changing rapidly. Whilst encouraging, it should be noted that all options have associated adverse side-effects so consult your medical doctor for more information.